아동을 대상으로 한 감각통합중재 효과에 관한 메타 분석: 국내연구를 중심으로

홍은경 ( Hong Eun Kyoung ),김경미 ( Kim Kyeong Mi ) 대구대학교 특수교육재활과학연구소 2014 특수교육재활과학연구 Vol.53 No.3

본 연구의 목적은 아동을 대상으로 실시 한 감각통합중재의 효과를 알아보고자 하였다. 연구 대상 논문을 선정하기 위해 RISS, KISS, DBpia, 국회도서관의 데이터베이스를 이용하여 2014년 2월까지의 자료를 검색하였다. 사용한 검색어는 “감각통합”, “통합감각”, “감각”, “통합”, “감각운동”, “감각자극”이었다. 최종적으로 분석된 논문은 총 10편이었고, 이를 대상으로 체계적 고찰 및 메타분석을 실시하였다. 분석한 결과, 아동에서 감각통합중재는 효과가 있었다. 특히, 감각통합중재는 감각-지각 기능과 운동 기능에서 큰 효과크기를 나타내었다. 본 연구의 결과는 아동을 대상으로 개별 감각통합중재를 실시하는 국내의 임상가들에게 증거-기반의 자료가 될 것이다. The purpose of this study is to look at a systematic review and meta-analysis on the effects of sensory integration intervention for children. Through this comprehensive study, we have to standardize and compare the studies. Ten researches were searched by RISS, KISS, DBpia data base. Key words were “sensory integration”, “sensory”, “integration”, “integration sensory”, “sensory motor”, and “sensory stimulation” for search. In the result of analysis, sensory integration intervention had positive effects. Particularly, effects of sensory integration intervention showed big effect size on sensory-perception function and motor function. The results of this study will apply to clinical interventions as evidence-based sensory integration intervention.

담낭용종으로 진단되었던 황색육아종성 담낭염

홍은경(Eun Kyoung Hong),장명준(Myeong Jun Chang),강경우(Kyeong Woo Kang),전용철(Yong Cheol Jeon),이명석(Myung Seok Lee),김우중(Woo Joong Kim),심정원(Jung Weon Shim),이영철(Young Chul Rhee),정수영(Soo Yeong Jeong) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4

Xanthogranulomatous cholecystitis is an uncommon focal or diffuse destructive inflammatory lesion of the gallbladder. It is characterized macroscopically by yellowish tumor-like mass in the wall of the gallbladder, and microscopically characterized in the early stages by a large number of foamy histiocytes and acute inflammatory cells, and in the )ater stages by increasing fibrosis. It has been usually mistaken for gallbladder cancer and often seen with stones. A case is presented in which a 59-year-old woman with clinical gallbladder cholesterol polyp was found at surgery to have a edematous and thickened wall of gallbladder, multiple black pigmented stones and 3 x 0.5cm sized yellowish mass on gallbladder bed which was confirmed later as xanthogranulomatous cholecystitis, pathologically. (Korean J Gastroenterol 1996;28:582 - 586)

청각자극의 세기에 따른 노인의 인지 반응시간 분석

김경미,장문영,홍은경,Kim, Kyeong-Mi,Chang, Moon-Young,Hong, Eun-Kyoung 대한감각통합치료학회 2007 대한감각통합치료학회지 Vol.5 No.1

Objective: The purpose of this study was to get the cognitive reaction time according to the intensity of auditory stimuli in older people and to differentiate the cognitive reaction time between older people and adults. Method: 49 subjects consisted of 32 older people and 17 adults. Cognitive reaction time was assessed with Simple Auditory Reaction of Foundation I in PSS CogReHab. Analysis of the data was done by using independent t-test. Results: The results were as follows: 1. There was a significant difference of the mean of cognitive reaction time to the intensity of auditory stimuli. 2. There was no significant difference from older people regardless of sexual distinction in mean of cognitive reaction time. However, there was a significant difference of the mean of cognitive reaction time in adults. 3. There was a significant difference between older people who got a job or not in 90 dB of auditory stimuli. 4. The mean of cognitive reaction time to the intensity of auditory stimuli in older people was slower than adults. There was a significant difference of the mean of cognitive reaction time between older people and adults in 70 dB of auditory stimuli. 5. The mean of cognitive reaction time to the intensity of auditory stimuli in older people did not have the significant difference in scholastic ability. Conclusions: The results of the study showed slowing of the cognitive reaction time in auditory stimuli to aging in older people. Therefore, applying silver industry and development of equipment for older people may maintain independent life.

대학생의 생명의료윤리의식과 안락사에 대한 태도

이혜림(Hye-Rim Lee),홍은경(Eun-Kyoung Hong),김경미(Kyeong-Mi Kim) 한국엔터테인먼트산업학회 2016 한국엔터테인먼트산업학회논문지 Vol.10 No.1

대학생들의 생명의료윤리의식과 안락사에 대한 태도를 파악하여 바람직한 생명윤리관 확립과 앞으로의 생명윤리교육을 위한 기초자료를 제공하고자 한다. G군에 있는 A대학교 대학생 대상으로 회수된 설문지 중 정확히 기입된 275부를 대상으로 조사 연구하였다. 연구결과는 생명의료윤리의식은 태아의 생명권영역이 가장 높게 나왔으며 뇌사 영역이 가장 낮게 나왔다. 안락사에 대한 태도는 대상자의 권리 영역에서 가장 높은 점수가 나왔으며 의료윤리 영역이 가장 낮게 나타났다. 일반적인 정보에 따른 안락사에 대한 태도는 유의미한 차이가 없었다. 생명의료윤리의식과 안락사에 대한 태도 간의 상관관계는 음의 상관관계로 나타났다. 이러한 결과로 앞으로 사회에서 다양한 의사 결정을 해야 할 상황과 윤리적 갈등에 대비하여 예비사회인에게 생명의료윤리에 관한 체계적인 교육이 필요하다는 것을 제안하고자 한다. This study sought to provide basic for the establishment of desirable sense of ethics values by analyzing the consciousness of biomedical ethics and attitudes to euthanasia of undergraduate students. The subjects of the study were 275 undergraduate students, major in occupational therapy and physical therapy students. The periods of data collection was from May 15 to 20, 2015 and collected data were analyzed on SPSS ver.18 program. The result is followed first the mean score of the consciousness of biomedical ethics was 2.79. While the mostly high ranked category of biomedical ethics was the right to life Fetus(3.42), the category with the lowest score was the Brain death(2.33). and the mean score of the attitudes to euthanasia was 2.82. Second with respect to the characteristics of participants there were not statistically significant difference in biomedical ethic and attitudes to euthanasia of total score according to sex, student’s major, grades, religion, participation of religious activity, except with ethical value. Third, the awareness of biomedical ethics and attitude of euthanasia showed significant negative correlation. As a result, for appropriate consciousness of biomedical ethics of undergraduate students, a curriculum will develop validly and must include to biomedical ethic subject in the future.

재발성 뇌수막종의 진행적 악성 형질 변환 : 증례 보고

이원석 ( Won Seok Lee ),곽호신 ( Ho Shin Gwak ),홍은경 ( Eun Kyeong Hong ),유헌 ( Heon Yoo ) 대한뇌종양학회 대한신경종양학회 2014 Brain Tumor Research and Treatment Vol.2 No.1

We report a case of 39 year old man with stepwise malignant progression from benign to anaplastic meningioma with a transition of atypical meningioma. He received the 1st time craniotomy 5 years ago for parasagittal meningioma and the histopathological diagnosis was benign meningioma of WHO grade 1. Radiation was given to residual tumor at 54 Gy/27 fractions. Four years after the craniotomy, the tumor recurred. Second craniotomy was done and the biopsy was atypical meningioma of WHO grade 2. Residual tumor in the superior sagittal sinus regrew one year later and the third craniotomy was done with excision of involved superior sagittal sinus. The pathological diagnosis was still atypical meningioma, then. Three months after the 3rd craniotomy, the tumor recurred on both parasagittal area and remote cortical surface. The 4th craniotomy was done and the biopsy was turned out to be anaplastic meningioma of WHO grade 3. Adjuvant chemotherapy was given one month after, and the tumor showed mixed response of partial remission and new lesion. The 5th craniotomy was done for both residual tumor and bone flap infection and adjuvant chemotherapy was given again. Five months later, stereotactic radiosurgery was performed for residual enhancing lesion, which was in stable state. With this case, we`d like to discuss about possible genetic alterations associated with the malignant transformation of meningioma, and what can be effective therapy for such residual or recurrent meningiomas.

재발성 뇌수막종의 진행적 악성 형질 변환 증례 보고

이원석 ( Won Seok Lee ),곽호신 ( Ho Shin Gwak ),홍은경 ( Eun Kyeong Hong ),유헌 ( Heon Yoo ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.2

We report a case of 39 year old man with stepwise malignant progression from benign to anaplastic meningioma with a transition of atypical meningioma. He received the 1st time craniotomy 5 years ago for parasagittal meningioma and the histopathological diagnosis was benign meningioma of WHO grade 1. Radiation was given to residual tumor at 54 Gy/27 fractions. Four years after the craniotomy, the tumor recurred. Second craniotomy was done and the biopsy was atypical meningioma of WHO grade 2. Residual tumor in the superior sagittal sinus regrew one year later and the third craniotomy was done with excision of involved superior sagittal sinus. The pathological diagnosis was still atypical meningioma, then. Three months after the 3rd craniotomy, the tumor recurred on both parasagittal area and remote cortical surface. The 4th craniotomy was done and the biopsy was turned out to be anaplastic meningioma of WHO grade 3. Adjuvant chemotherapy was given one month after, and the tumor showed mixed response of partial remission and new lesion. The 5th craniotomy was done for both residual tumor and bone flap infection and adjuvant chemotherapy was given again. Five months later, stereotactic radiosurgery was performed for residual enhancing lesion, which was in stable state. With this case, we’d like to discuss about possible genetic alterations associated with the malignant transformation of meningioma, and what can be effective therapy for such residual or recurrent meningiomas.

그룹감각통합치료가 아동의 놀이와 또래 상호작용에 미치는 영향

홍은경,김경미 대한감각통합치료학회 2009 대한감각통합치료학회지 Vol.7 No.1

Objective : The purpose of the study is to find out how group sensory integrative (SI) intervention enhances play skill and social interaction of the children with sensory integration disorders. Method : Three children who were showing problems related in sensory integration received 12 SI intervention sessions. The Sensory Profile (SP) and The Social Maturity Scale (SMS) were accomplished by the subject’s primary caregiver. Test of Playfulness (ToP) and Peer Social Interactions Rating Scale (PSIRS) were utilized to investigate the children’s play skills and social interactions with their friends. Goal Attainment Scale (GAS) is applied to assess the children’s play skill, social interactions with peer, and sensory processing at each session. Data was collected before- and after the intervention and analyzed by the Wilcoxon matched-pair signed rank test with SPSS/WIN version 10.0 and Microsoft Excel. Results : The average scores of ToP, PSIRS, and SMS were increased after the sensory integrative intervention. However, there is no significant difference in the play skills and social interactions between data of pre-intervention and the one of post-intervention. The score of the GAS was frequently increased in terms of the play skills and sensory processing throughout the whole sessions. Conclusions : This study reveals a possibility of that the group sensory integrative intervention may affect not only sensory processing ability, but also play skills and social interactions of children experiencing difficulties of sensory processing. Future research should supplement limitations of this study regarding insufficient number of the subject and the short period of the experiment. 목적 : 본 연구는 감각처리장애아동에서 그룹 감각통합치료의 적용 후에 놀이와 또래와의 상호작용에 미치는 영향을 알아보기 위한 것이다. 연구방법 : 실험대상은 B지역에 거주하는 3-7세의 감각통합장애가 있는 아동 3명이었다. 평가는 그룹 감각통합치료 프로그램 전과 후에 감각처리능력과 놀이 기술, 그리고 또래와의 상호작용으로 나누어 실시하였다. 모를 통해 감각처리능력의 Sensory Profile과 또래와의 상호작용의 사회성숙도 검사를 하였고, 관찰을 통해 놀이 기술의 The Test of Playfulness와 또래와의 상호작용의 Peer Social Interactions Rating Scale을 평가하였다. 그룹 감각통합치료 프로그램 회기 동안에는 Goal Attainment Scale를 통해 감각처리능력과 놀이 기술, 그리고 또래와의 상호작용을 평가하였다. 그룹 감각통합치료 프로그램은 촉각, 전정감각, 고유수용성감각을 위주로 하여 구성하였고, 4주간 총 12회기 실시되었다. 연구결과는 SPSS/WIN 버전10.0과 엑셀을 사용하여 통계분석 하였다. 결과 : 그룹 감각통합치료 프로그램 적용 전과 후에 놀이기술과 또래와의 상호작용에서 통계적으로 유의한 차이는 보이지 않았다. 그룹 감각통합치료 프로그램 동안 평가한 GAS의 결과, 놀이기술과 감각처리에서 점차 향상된 모습을 보였다. 결론 : 본 연구 결과는 그룹 감각통합치료 프로그램이 감각통합장애아동에서 놀이기술과 또래와의 상호작용에 긍정적인 영향을 미친다고 명확하게 결론짓기에는 한계가 있다. 그러나 대상의 수와 실험기간을 늘려 치료를 적용한다면, 더 긍정적인 결과가 나올 것으로 예상된다.

시운동기술에 관한 아동 작업치료의 체계적 고찰

홍은경,김경미 대한감각통합치료학회 2010 대한감각통합치료학회지 Vol.8 No.1

목적 : 체계적 고찰을 통해 시운동기술 평가를 위해 사용된 도구, 치료접근방법, 치료의 효과를 알아보고, 아동의 시운동 기술에 가장 적합한 치료방법과 평가도구를 제시하고자 한다. 연구 방법 : 체계적 고찰을 사용하였다. 2001년 1월부터 2010년 6월까지 학회지에 게재된 논문을 PubMed을 통하여 검색하였다. 주요 검색용어는 "visual motor and occupational therapy", "visuomotor and occupational therapy"," perception and motor and occupational therapy" 이었고, 161개의 논문 중 총 13개 논문을 대상으로 분석하였다. 결과 : 1. 시운동기술 치료가 필요한 대상 진단군은 발달장애아동이 20.00%로 가장 많았고, 글씨쓰기에 문제가 있는 아동이 13.33%이었다. 결과 : 2. 시운동기술을 측정하기 위해 사용된 평가도구는 Developmental Test of Visual Perception(DTVP)을 사용한 논문이 33.33%로 가장 많았고, Developmental Test of Visual Motor Integration(VMI)을 사용한 논문이 26.67%이었다. 결과 : 3. 시운동기술과 관련하여 가장 많이 사용된 치료접근방법은 발달적 기술기반 프로그램으로 58.82%를 차지하였고, 감각통합과 감각기반 치료는 23.53%를 보였다. 결과 : 4. 시운동기술과 관련하여 작업치료 효과가 유의하게 나타난 경우는 72.73%이었고, 유의하지 않는 경우가 9.09%이었다. 부모 직접적 또는 간접적 접근과 집중행동 치료에서 효과가 유의하게 나타났다. 결론 : 아동 작업치료에서 시운동기술을 평가하기 위해 사용된 도구는 DTVP와 VMI가 60%를 차지하였고, 70%이상에서 치료에 대한 효과가 있는 것으로 나타났다. 아동의 작업수행과 관련된 영역에 대한 작업치료의 효과를 분석하는 연구가 지속되어야 할 것으 로 보인다. Objective : This study tried to identify evaluation tools and intervention approaches that have been used regarding visual motor skills of children, in order to suggest the best evaluation method and intervention strategy. Methods : This study employed a systemic review. Papers researched for the review were selected from the PubMed which is a web engine to search academic articles. For search, time period of publication was limited from January 2001 to Jun 2010, and key words used were "visual motor and occupational therapy", "visuomotor and occupational therapy", and "perception and motor and occupational therapy". 13 papers among total 161 findings were selected for data analysis. Results : Through literature review, followings were founded. For population targeted in studies, children with developmental disorder are majority(20.00%) and those with handwriting problems are another major group(13.33%). DTVP(33.33%) and VMI(26.67%) are most common tools used to evaluate visual motor skills. Most frequently used intervention method is developmental skill based program(58.82) and the second common method is sensory integration therapy and sensory-based intervention(23.53%). Regarding the effectiveness of occupational therapy for visual motor skill, positive evidences with statistical power take 72.73%. Conclusion : The results imply that occupational therapy is effective for visual motor skill in children. It is suggested that further studies are needed to encompass effectiveness of occupational therapy in terms of children’s occupational performance.

Ayres의 감각통합중재 중심원리에 따른 치료사의 치료수행도 조사

홍은경,김경미,장문영 대한감각통합치료학회 2011 대한감각통합치료학회지 Vol.9 No.1

목적 : 본 연구에서는 자기-평가 방법을 이용하여 Ayres의 감각통합중재 중심 원리를 바탕으로 한 치료사의 치료적 수행 정도를 알아보고자 하였다. 연구방법 : 연구기간은 2010년 5월부터 6월까지이었고, 연구대상은 감각통합중재를 하고 있는 치료사 66명이었 다. 자기 기입식 설문지를 이용하여 Ayres의 감각통합중재 중심원리에 따라 치료를 수행하는 정도를 자기-평가 하도록 하였다. 설문지는 감각의 기회제공, 적절한 도전의 과제 제공, 활동을 선택할 기회 제공 등 Ayres의 감각통 합중재 중심 원리에 대한 10가지 항목으로 구성하였다. 총 66부의 수거된 설문지는 기술통계를 이용하여 분석하 였고, T 값을 통해 퍼센타일을 알아보았다. 결과 : 모든 치료사들은 Ayres의 감각통합중재 중심 원리의 10가지를 모두 고려하여 치료하는 것으로 나타났다. 10가지 Ayres의 감각통합중재 중심 원리 중 자기 조직화 가이드 중심 원리를 제외하고 90%이상에서 종종, 자주, 항상 고려하여 치료하고 있었다. 감각의 기회제공, 적절한 과제제공, 활동 선택 기회제공, 아동의 성공을 최대화, 신체적 안전성 보장, 치료적 존중의 감정 조성은 T 값 50점 이상을 나타냈다. 자기 조직화 가이드, 적절한 각성 유 지, 놀이 환경의 조성, 아동이 치료실 정리에 참여는 T 값 50점 이하를 나타냈다. 결론 : 지속적인 Ayres의 감각통합중재 중심 원리에 따른 치료사의 자기 수행에 대한 평가를 통해 치료의 질을 점 검하고 높이는 것이 필요하다. Purpose : In this study, we tried to know that how the occupational therapists applied the core principles of Ayres's sensory integration(ASI) intervention for clients by using the method of self-assessment. Methods : The study period was from May 2010 to June 2010. The subjects were therapists who use a sensory integration intervention. We letted them to do self-assessment about degree of performing the treatment according to the core principles of ASI by using a questionnaire. Total 66 questionnaires were collected. SPSS for Windows version 15.0 was statistically analyzed. Results : There wasn't anybody without considering the 10 core principles of ASI interventions for children. Therapist's answer(more than 90%) was sometimes, often, always except for the guide self-organization in the 10 core principles of ASI intervention. On the basis of total average score of raw score of 10 core principles of ASI intervention, provide sensory opportunities, provide just-right challenges, collaborate on activity choice, maximize child's success, ensure physical safety, and foster therapeutic alliance showed more than 50 points(T value). The guide self-organization, support optimal arousal, create play context, and arrange room to engage child showed less than 50 points T value. Conclusion : The most effective interventions for sensory integration is the treatment based on the core principles of ASI intervention. According to core principle of ASI intervention, checking the quality of care and increasing the quality of care is needed through performing self-assessment.

Ayres 감각통합치료를 바탕으로 한 중심원리, 치료역량, 환경요소의 상관관계

홍은경,김경미,장문영 대구대학교 특수교육재활과학연구소 2012 특수교육재활과학연구 Vol.51 No.4

본 연구는 국내 임상에서 감각통합치료를 사용하는 치료사를 대상으로 Ayres 감각통합치료의 중심원리를 적용하는 정도를 조사하였다. 연구의 목적은 Ayres 감각통합치료 이론을 바탕으로 한 중심원리, 치료사의 역량 요소, 환경 요소 사이의 상관관계를 알아보는 것이었다. 연구의 대상은 병원, 복지관 등 감각통합치료를 적용하는 66명의 치료사들이었다. 2010년 5월 12일부터 2010년 6월 21일까지 설문지를 이용하여 조사하였다. 중심원리와 각 요소들 사이의 상관관계를 알아보기 위해 Pearson Correlation을 이용하여 분석하였다. 연구의 결과, Ayres 감각통합치료의 중심원리는 치료사의 역량 요소인 치료사의 임상 경험, 교육의 양과 긍정적인 상관관계를 보였다. Ayres 감각통합치료의 중심원리는 환경 요소인 치료 도구의 유형, 치료실 세팅 정도와 긍정적인 상관관계를 나타냈다. 본 연구는 임상에서 치료사들이 치료의 질을 향상시키기 위해 Ayres 감각통합치료의 중심원리 뿐만 아니라 치료사의 역량과 환경이 중요함을 제시하는데 의의가 있다. We investigated how often occupational therapists have used factors of Ayres Sensory Integration® (ASI) intervention in their clinical practice in Korea. The aim of this study was to explore the relationships between the core principles, elements of therapist qualification, and elements of environmental design based on ASI intervention. The study subjects were therapists that apply sensory integration therapy in hospitals and rehabilitation facilities. We utilized questionnaires using a self -assessment method for 66 therapists. The questionnaire investigation was conducted between May 12th, 2010 and June 21st, 2010. The core principles based on ASI intervention had moderate or mild correlation with the therapists’ clinical experience, amount of formal education, type of therapeutic equipment, and room setup. The study provides the therapist qualification and environmental design are very important to improve quality of intervention in clinical practice. Results of this study suggest therapist should be careful about the core principles based on ASI intervention as well as therapist qualification and environmental design.